- Our BTRU continues to lead internationally in the area of ex vivo organ perfusion research by building on successful collaborations between several themes. Pioneering work in Theme 1 has led to the adoption of ex situ normothermic liver perfusion as the standard of care throughout the UK. Transcriptomic analysis (Theme 7) has identified a signature for reperfusion injury in the liver (Theme 1) and for delayed graft function in the kidney (Theme 4). Ex vivo thrombolysis is being investigated to improve early allograft function in both kidneys and livers. In the cardiothoracic arena, the increasing numbers of organs available for research (INOAR) initiative has been successfully launched and is already facilitating research into heart and lung perfusion studies.
- We also continue to lead on in situ perfusion. Professor Watson in Cambridge (Theme 1) has worked closely with the Edinburgh group and led the national implementation of in situ normothermic regional perfusion (NRP) in the UK. Data from this group show that NRP increases the utilisation of livers and kidneys from donors with circulatory death and improves allograft survival rates. Nationally funded programmes have been agreed in Scotland and Wales and NHSBT is submitting a case to DHSC for funding in England.
- This year the BTRU completed recruitment to the multicentre randomised controlled trial (RCT) of normothermic machine perfusion (NMP) in kidney transplantation from donation after circulatory death (DCD) donors (n=338 patients). Recruitment was completed on schedule in April 2020. This is the world’s first randomised clinical study of NMP in renal transplantation and has been led by Dr Sarah Hosgood and Prof Michael Nicholson in Cambridge and Mr Colin Wilson in Newcastle, working with colleagues at Guy’s Hospital (Lead: Mr Chris Callaghan) and Edinburgh (Lead: Mr Gabi Oniscu). Data collection is complete, with all patients having been followed up for 12 months post-transplantation. NHSBT statisticians are supporting the trial and the data analysis should be completed in the next few months. The aim will then be to submit a manuscript to one of the leading and highest impact factor journals.
- BTRU funded research fellows continue to present their research at national and international meetings and to publish in high impact peer-reviewed journals. As an indicator of the quality of the work being generated within the BTRU, during 2020–21 our fellows received the following prestigious awards for NIHR-funded research:
- Emily Thompson (PhD student in Newcastle supervised by Mr Colin Wilson and Prof Neil Sheerin) won the 2021 Patey Prize at the Surgical Research Society for her paper entitled ‘Ex vivo normothermic machine perfusion facilitates gymnotic delivery of RNA interference therapeutics in donor kidneys’. The Patey Prize is widely regarded as the highest award for surgical research in the UK.
- Jenna DiRito (PhD student in Cambridge supervised by Dr Sarah Hosgood and Prof Mike Nicholson) was awarded the 2020 Cambridge Society for the Application of Research PhD Student Award in recognition of research with real world application and the 2021 British Transplantation Society Roy Calne Award for the best transplant manuscript published in the preceding 2 years. Both of these awards were for work into lysis of cold storage induced microvascular obstructions for ex vivo revitalisation of marginal human kidneys.
- Sarah Hosgood (Senior Research Associate in Cambridge) was awarded the 2020 Association of Surgeons and NIHR Best Surgical Innovation Award for a novel 3D printed organ perfusion chamber for normothermic machine perfusion of transplant kidneys.
- We were thrilled this year to be successful in our application to the Cambridge Creative Encounters project, which brings together researchers and freelance illustrators/filmmakers to work together and showcase research in new and innovative ways. We were paired with freelance illustrator Jess Nash to work on a ‘creative short‘ (a gif) to illustrate our normothermic machine perfusion technology. We were delighted with the final outcome, which we’re using to enhance our public engagement work and raise the profile of this important area of research.
- This year we made progress towards our long-term goal of sharing our experiences with patient and public involvement and engagement (PPIE) with the wider healthcare community. We successfully secured funding from the Tilly Hale & Engage FMS ‘Celebrating Excellence in PPIE’ funding scheme at Newcastle University to support a project entitled ‘Great expectations: Building a shared understanding of the role of lay co-applicants in biomedical research’. We held a shared learning workshop in May 2021 with public and patient members, clinicians and researchers from the four NIHR BTRUs attending, as well as public and patient representatives from beyond the field of transplantation. Key outcomes from the workshop will be used to co-produce a video animation to share the learning and help researchers and patient and public contributors understand expectations for each other.